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PubMed2005

Plantar pressure distribution analysis in normal weight young women and men with normal and claw feet: a cross-sectional study.

We analyzed the plantar support in 72 normal-weight young voluntaries (46 women, 26 men), by a baropodometric platform. We considered subjects with claw foot (CFS) and subjects with normal foot (NFS). We found a significant reduction of total plantar support surface in the CFS (P < 0.0001 for women, P < 0.001 for men), due to the reduction of the forefoot and rear foot areas of both plantar imprints. Indeed, CFS of both sexes exhibited higher values of both plantar pressure and peak pressure, compared to the NFS. Moreover, the load per units of plantar surface increased in CFS compared to the NFS. In conclusion, the reduction of plantar support surfaces in CFS of both sexes was associated to a major load per units of plantar surface in the forefoot and rear foot areas, and this may be a risk factor to lower extremity overuse injuries.

Adolescent↗
PubMed1987

Mechanical behavior of the human lumbar spine. II. Fatigue strength during dynamic compressive loading.

Seventeen cadaveric human lumbar motion segments from eight spines were cyclically loaded in vitro under axial compression. Loading frequency and magnitude were chosen to simulate rigorous activity within an in vivo physiological level. The load magnitude was determined as a percentage of the ultimate compressive load, the latter estimated from the bone mineral content (BMC) of lumbar vertebrae determined by dual-photon absorptiometry. Following testing, the degree of macroscopic disc degeneration was assessed and the type of fracture in each specimen was determined from serial sagittal sections. Fractures were found in all but one specimen. Three types of fractures were formed: the node of Schmorl and Junghanns (type I), central endplate fracture (type II), and a crush or burst fracture (type III). The results suggested that type I fractures were predominantly associated with segments with normal discs, type II fractures were found primarily in segments with moderately degenerated discs, and type III fractures were associated with segments that failed on the first cycle. Segment stiffness and fatigue strength (cycles to failure) were correlated with disc degeneration, age, and segment BMC, the latter an in vivo measure of bone density. Fatigue strength also decreased in proportion to a power coefficient with increasing relative stress (cyclic stress range/ultimate stress).

Adult↗
PubMed1991

Relationship between lower limb dynamics and knee joint pain.

To test the hypothesis that appropriate and timely neuromuscular control of limb motions plays an important role in the preservation of joint health, we kinematically and kinetically examined the behavior of the legs of young adult subjects at heel strike during natural walking. We compared a group of 18 volunteers, who, we presumed, were preosteoarthrotic because of mild, intermittent, activity-related knee joint pain, with 14 age-matched asymptomatic normal subjects. The two groups of subjects exhibited similar gait patterns with equivalent cadences, walking speeds, terminal stance phase knee flexion, maximum (peak) swing angular velocity, and overall shape of the vertical ground reaction. However, our instrumentation detected statistically significant differences between the two groups within a few milliseconds of heel strike. In the knee pain group, the heel hit the floor with a stronger impact in this brief interval. Just before heel strike, there was a faster downward velocity of the ankle with a larger angular velocity of the shank. The follow-through of the leg immediately after heel strike was more violent with larger peak axial and angular accelerations of the leg echoed by a more rapid rise of the ground reaction force. This sequence of events represents repetitive impulsive loading, which consistently provoked osteoarthrosis in animal experiments. We refer to this micro-incoordination of neuromuscular control not visible to the naked eye as "microklutziness."

Adult↗
PubMed2007

The effect of eccentric exercise on position sense and joint reaction angle of the lower limbs.

Impaired position sense and impaired joint reaction angle of the lower limbs after muscle-damaging activities is a serious functional limitation that may lead to an increased risk of injury, particularly in older populations. The purpose of the present study was to examine whether position sense and joint reaction angle to release can be affected by eccentric exercise-induced muscle damage. Twelve women underwent an isokinetic exercise session of the lower limb. Isometric peak torque, delayed-onset muscle soreness, serum creatine kinase, position sense, and knee joint reaction angle to release were examined before, immediately after, and 24, 48, and 72 h post-exercise. Due to the effect of eccentric exercise, subjects persistently placed their lower limb at a more extended position, representing a shorter knee extensor muscle. Eccentric exercise increased the knee reaction angle of the lower limb after release from 0 degrees and 15 degrees but not from 30 degrees and 45 degrees . Position sense and joint reaction to release were similarly affected by eccentric exercise and independently of visual feedback. Position sense was impaired only immediately post-exercise (probably due to muscle fatigue), whereas impairment of the reaction angle to release persisted up to 3 days post-exercise (probably due to muscle damage). Attenuation of position sense and joint reaction angle of the lower limbs after damaging activities is a serious functional limitation that may lead to an increase risk of injury, particularly in older populations.

Adult↗
PubMed1998

Motivating factors for return to work.

BACKGROUND AND PURPOSE: A new concept to increase return to work for patients listed as sick with chronic musculoskeletal pain has been used at a rehabilitation centre in Luleå, Sweden. The programme includes work for three days a week and intensive rehabilitation for two days a week, for 12 weeks, as a combination of 'on the job' training and rehabilitation after a period off work sick. The rehabilitation programme focused on pain reduction, identifying and finding solutions to pain problems in actual work and life situations and training of the functional capacities needed in the work and life situation. The aim of the study was to describe patients' perceptions of motivating factors for return to work. METHODS: A phenomenological method was used. A naïve reading of interview notes was followed by structural analyses and reflections on the interpreted whole. Inclusion criteria for the study were musculoskeletal pain for at least one year and a period of at least four weeks' sick leave during that time. Ten patients, aged 30-54 years, participated in the study. An initial conceptual framework was developed to inform the scope of the study and to guide data collection and analysis. RESULTS: Different factors in the study framework influenced motivation to return to work. Among structural factors the division of labour at work was the most important motivator, particularly the ability to do as much as work colleagues, quantitatively and qualitatively. All the patients had jobs in the healthcare or service sectors, jobs with many social contacts. They perceived their work task content as being of minor importance compared to whether the tasks were perceived as meaningful or highly needed by others. All wanted a meaningful job content and a job which they could do in a satisfactory way according to their own norms and compared to colleagues. This highly increased motivation for return to work. Relationships (in terms of co-operation with colleagues and service to patients or clients) were important motivating factors for return to work. Self-confidence was a new factor of importance for return to work; work tasks had to be meaningful and needed by others, work must be done in a way satisfactory for the individual and in a way that was acceptable to others in the group. Everyday responsibility, feedback and support in daily work tasks were important. These aspects increased self-confidence. The results supported the development of a new conceptual framework for possible motivating factors for return to work. CONCLUSIONS: Structure, content, relationships, health and self-confidence were all important motivating factors for return to work.

Adult↗
PubMed1999

Injuries and risk factors in a 100-mile (161-km) infantry road march.

BACKGROUND: Light infantry soldiers (N = 218) completed a 161-km cross-country march over 5 days carrying an average +/- SD load mass (i.e., the weight of all equipment and clothing) of 47 +/- 5 kg. METHODS: Prior to the march, height, weight, body fat, and physical fitness (3.2-km run, sit-ups, push-ups) were measured. Soldiers completed a demographic questionnaire which included questions on age and tobacco use history. RESULTS: Thirty-six percent (78/218) of the soldiers suffered one or more injuries. Of the total injuries, 48% presented were blisters and 18% were foot pain (not otherwise specified). Eight percent (17/218) of the soldiers were unable to complete the march because of injuries. Thirty-five percent (27/78) of the injured soldiers had 1 or more limited duty days for a total of 69 days. Risk of injury was higher among smokers (risk ratio = 1.8, P = 0.03 compared to nonsmokers) and lower among older soldiers (risk ratio = 3.2, P = 0.02, < 20 years compared to > 24 years). CONCLUSIONS: Carrying heavy loads over long distances can result in a high injury incidence to the lower body, since 36% of soldiers were injured during the 161-km march. Smoking and younger age (< 20 years) were independent risk factors for injuries.

Adult↗
PubMed1995

Aneurysm of the superficial palmar arch. A case report.

We describe a case of compression of the median nerve by an aneurysm of the superficial palmar arterial arch which presented with symptoms of the carpal tunnel syndrome. The traumatic and occupational nature of true palmar aneurysms are discussed.

Aneurysm↗
PubMed1988

Unusual cough related stress injuries.

Two cases of unusual cough related stress injuries of the ribs are described. Both were detected on a 2 h delay bone scan. To our knowledge, cough stress injuries have been not previously described scintigraphically.

Adult↗
PubMed1993

Physiological and subjective responses to maximal repetitive lifting employing stoop and squat technique.

To establish safe levels for physical strain in occupational repetitive lifting, it is of interest to know the specific maximal working capacity. Power output, O2 consumption, heart rate and ventilation were measured in ten experienced forestry workers during maximal squat and stoop repetitive lifting. The two modes of repetitive lifting were also compared with maximal treadmill running. In addition, electromyogram (EMG) activity in four muscles was recorded and perceived central, local low-back and thigh exertion were assessed during the lifting modes. No significant difference was found in power output between the two lifting techniques. Despite this the mean O2 consumption was significantly greater during maximal squat lifting [38.7 (SD 5.8) ml.kg-1.min-1] than maximal stoop lifting [32.9 (SD 5.7) ml.kg-1.min-1] (P < 0.001). No significant correlation was found between O2 consumption (in millilitres per kilogram per minute) during maximal treadmill running and maximal stoop lifting, while O2 consumption during maximal squat lifting correlated highly with that of maximal treadmill running (r = 0.928, P < 0.001) and maximal stoop lifting (r = 0.808, P < 0.01). While maximal heart rates were significantly different among the three types of exercise, no such differences were found in the central rated perceived exertions. Perceived low-back exertion was rated significantly lower during squat lifting than during stoop lifting. The EMG recordings showed a higher activity for the vastus lateralis muscle and lower activity for the biceps femoris muscle during squat lifting than during stoop lifting. Related to the maximal voluntary contraction, the erector spinae muscle showed the highest activity irrespective of lifting technique.

Back↗
PubMed1990

Pattern of muscle activity during stereotyped work and its relation to muscle pain.

Standardized and machine-paced work tasks at a packing machine were examined to evaluate interindividual variability of muscle activity patterns. Ten trained female workers, without musculo-skeletal complaints at the time of the recording, performed the work tasks while electromyographic (EMG) recordings were obtained from both upper trapezius muscles. Static muscle activity and periods of between 0.2 and 2 s duration with low muscle activity, EMG gaps, were analysed. Complaints of muscular fatigue, soreness or pain in the neck and shoulders during the last 12 months were recorded. The level of static muscle activity was 1.6 (range 0.4 to 2.5) per cent of maximal voluntary contraction and median number of EMG gaps was 4.8 (range 0.8 to 20) per minute. Workers with previous episodes of complaints (five subjects) had higher levels of static muscle activity and fewer EMG gaps than workers without such episodes (p less than 0.05, Wilcoxon 2-sample test, one-tailed). Considerable interindividual variability of muscle activity patterns was found in spite of stereotyped work. No causal relations may be inferred from the correlation between the level of trapezius activity and complaints, though it indicates that individual, inexpedient muscle activity patterns may constitute an important risk factor for development of musculo-skeletal complaints.

Adult↗
PubMed1996

Knee moment at work: validation of a questionnaire based on knee moment in working life.

Classifications of occupations, such as those of the International Labor Organization, have previously been constructed with respect to the physical strain and joint moment to be expected in conjunction in a profession. To detect which occupational activities specifically induce high knee moments, we designed a questionnaire to analyze walking, knee bending, climbing of stairs and ladders, and jumping during three consecutive 15-year exposure periods in the professional lives of 920 consecutive residents [329 men with a mean age of 72 (range 47-96) and 561 women with a mean age of 77 (range 47-96)] drawn from the population records of the City of Malmö. The answers, classified into three categories with respect to knee joint moment, were compared with a classification of the occupations of all probands according to the same principles by three independent specialists in industrial hygiene. The two classifications showed a high degree of agreement, with Cramer's V ranging from 0.49 to 0.6, suggesting a co-variance with a common variable, i.e. the true work-related knee moment.

Age Distribution↗
PubMed1988

Stress fracture of the body of pubis in a pregnant woman. Case report.

A case with stress fracture of the body of the pubic bone which occurred in a 35-year-old pregnant woman is described. No underlying pathologic process was found and it would seem that the mechanical load acting on the pubic bone to cause stress fracture is brought about by both the muscle imbalance and ligament laxity. In a few weeks after delivery, the fracture showed a complete bony union.

Adult↗
PubMed1993

Individual and work-related risk factors associated with symptoms of musculoskeletal complaints.

Individual and work-related risk factors in the development of occupational musculoskeletal complaints were investigated in a cross-sectional study of 52 female production workers and 34 female office workers. The work tasks of the production workers were considered to generate shoulder muscle loads of low amplitude and high repetitiveness, and the work tasks of the office workers, muscle loads of low amplitude and low repetitiveness. The symptom scores were similar in the two groups, with the highest score for both groups in the shoulder-neck region. Previous pain symptoms were an important risk factor for musculoskeletal pain in all body regions, whereas psychosocial problems at work were a risk factor for complaints in the shoulder-neck region. For the office workers, 27% of the variance in shoulder-neck symptoms was explained by the variance in the parameters "previous pain symptoms" and "psychosocial problems" in a multilinear regression model. In three groups of workers with different physical loads on the shoulder muscles the symptom scores for workers without previous pain symptoms and psychosocial problems were related to the physical load. For workers with previous pain symptoms and psychosocial problems, the symptom scores were high and similar for all three groups.

Adult↗
PubMed1996

Hypothenar hammer syndrome in sports.

Repetitive blunt trauma or single severe trauma to the hypothenar region may lead to traumatic thrombosis of the distal ulnar artery (hypothenar hammer syndrome, HHS). In the sports-related literature we found and analysed isolated cases attributed to injuries sustained during sporting activities such as baseball, badminton, handball, football, frisbee, softball, karate, weight-lifting and hockey. Further, we report the case of an amateur golf player with ischaemic symptoms of his left hand, where angiography revealed filling defects in the digital arteries associated with a corkscrew-like configuration of the distal ulnar artery. Magnetic resonance imaging (MRI) scan demonstrated, at the level of the hamulus ossis hamati, accessory fibres of m. palmaris brevis forming a sling around the ulnar artery. Treatment by resection of the thrombosed a. ulnaris segment and replacement with an autologous vein graft resulted in complete relief of symptoms. Histological sections revealed partially organized thrombi adherent to the intimal surface with fragmentation of the internal elastic membrane, indicating a traumatic genesis. As the mechanism of injury, we suspected intensive golf playing with the grip style and subsequent motions leading to pressure injury of the hypothenar area and the underlying ulnar artery. Contraction of the anomalous muscle belly may have additionally compressed the artery, slowing down the arterial flow and promoting thrombosis. In most reported cases including our own, it took a relatively long time until the cause of the disease as traumatic was found and accepted. The initial repetitive blunt or single severe trauma initiating the HHS can easily be overlooked or ignored. After intimal damage of a. ulnaris, the beginning of symptoms may be prolonged and mislead one into thinking the cause is a collagen or vasospastic disease.

Adult↗